whether there were any differences in the patient experience for patients undergoing this type of surgery at our facility. Methods All patients undergoing forearm/hand fixations between May and November 2020 at a large teaching hospital were studied retrospectively. Cases with any RA component were compared with GA-only cases. Time in recovery, time to discharge, nausea, pain scores and post-operative opioid requirements were studied. Ethical approval was not required for this study, as per our local committee. Results 105 patients were included with results shown below. The breakdown of cases as wrist, proximal to wrist, and distal to wrist procedures were broadly similar in the RA group and GA group (78%,5%,17% vs. 89%,4%,7%) respectively. The incidence of severe pain was 3.5% (RA) vs. 41% (GA). The incidence of nausea was 2.5%(RA) vs. 9%(GA).
Background and Aims Major spinal surgery is a painful procedure requiring very high doses of intraoperative and postoperative opioids [1]. The majority of patients wake up in severe pain with many experiencing side effects from high opiate use [2]. Our primary aim was to investigate if an intraoperative intravenous infusion of ketamine and lidocaine mixture, when added to TIVA practice, improves pain scores in recovery and decreases the opioid amount used perioperatively.Both groups received perioperative Multimodal Analgesia MMA: Paracetamol, Clonidine, Magnesium Sulphate and Ketamine boluses (only for the first group, as for the second, Ketamine was added to the infusion). Methods A retrospective review of the medical records of patients undergoing major spinal surgery at RNOH was conducted.The patients were divided into two groups based on the type of main medications received:. Group 1: MMA plus Opioids . Group 2: MMA plus Opioids plus KLI Opioid doses were converted to morphine equivalents daily doses. Results Pain scores were significantly lower in Group 2, on average, 3 points lower than in Group 1. The opioid doses used in the Group 2 were over 3 times lower than those observed in Group 1. Median opioid dose for the first group was 24 [IQR 12,33] compared to median of 6 [IQR 0,18] for Group 2.Median time to wake up was 3 minutes in Group 2 compared to 20 mins in Group 1.
morphine use and pain scores between patients with a suprainguinal fascia iliaca block (FIB) with ropivacaine 0.375%, 40 mL and a control group (NB). Methods We conducted a retrospective, single-center study reviewing all data of elective total hip arthroplasties performed between April 2019 and May 2021. Primary endpoint is patient-controlled intravenous (PCIA) morphine use at 24 hours. Secondary endpoints were PCIA morphine use at 48 hours, NRS pain scores, perioperative sufentanil-, postoperative IV piritramide consumption on the PACU ward and nausea. The ethical committee of the Imelda hospital in Bonheiden deemed ethical approval unnecessary. Results Our study included 277 patients, consisting of 203 patients in the FIB group and 74 in the NB group. There was a significant decrease in PCIA morphine use (p = 0,000034) at 24 hours, lower pain scores at 48 hours (p = 0,0003) and lower sufentanil consumption perioperatively (p = 0,015) in the FIB group. However, pain scores and piritramide consumption in the PACU ward were significantly increased (p = 0,02 and p = 0,014, respectively) in the same group. No difference was reported for PCIA morphine use at 48 hours, pain scores at 24 hours and nausea.
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